Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA.
Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA.
Lung Cancer. 2019 Jul;133:96-102. doi: 10.1016/j.lungcan.2019.05.011. Epub 2019 May 11.
Although dramatic responses to MET inhibitors have been reported in patients with MET exon 14 (METex14) mutant non-small cell lung cancer (NSCLC), the impact of these treatments on overall survival in this population is unknown.
We conducted a multicenter retrospective analysis of patients with METex14 NSCLC to determine if treatment with MET inhibitors impacts median overall survival (mOS). Event-time distributions were estimated using the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox models were fitted to estimate hazard ratios.
We identified 148 patients with METex14 NSCLC; the median age was 72; 57% were women and 39% were never smokers. Of the 34 metastatic patients who never received a MET inhibitor, the mOS was 8.1 months; those in this group with concurrent MET amplification had a trend toward worse survival compared to cancers without MET amplification (5.2 months vs 10.5 months, P = 0.06). Of the 27 metastatic patients who received at least one MET inhibitor the mOS was 24.6 months. A model adjusting for receipt of a MET inhibitor as first- or second-line therapy as a time-dependent covariate demonstrated that treatment with a MET inhibitor was associated with a significant prolongation in survival (HR 0.11, 95% CI 0.01-0.92, P = 0.04) compared to patients who did not receive any MET inhibitor. Among 22 patients treated with crizotinib, the median progression-free survival was 7.4 months.
For patients with METex14 NSCLC, treatment with a MET inhibitor is associated with an improvement in overall survival.
虽然已有报道称 MET 外显子 14（METex14）突变型非小细胞肺癌（NSCLC）患者对 MET 抑制剂有显著反应，但这些治疗方法对该人群总生存期的影响尚不清楚。
我们对 METex14 NSCLC 患者进行了多中心回顾性分析，以确定 MET 抑制剂治疗是否影响中位总生存期（mOS）。采用 Kaplan-Meier 法估计事件时间分布，并采用对数秩检验进行比较。采用多变量 Cox 模型估计风险比。
我们共纳入 148 例 METex14 NSCLC 患者；中位年龄为 72 岁；57%为女性，39%为从不吸烟者。34 例未接受 MET 抑制剂治疗的转移性患者的 mOS 为 8.1 个月；其中合并 MET 扩增的患者与无 MET 扩增的患者相比，生存趋势较差（5.2 个月比 10.5 个月，P=0.06）。27 例转移性患者至少接受过一次 MET 抑制剂治疗，其 mOS 为 24.6 个月。调整首次或二线接受 MET 抑制剂治疗作为时间依赖性协变量的模型表明，与未接受任何 MET 抑制剂治疗的患者相比，接受 MET 抑制剂治疗可显著延长生存时间（HR 0.11，95%CI 0.01-0.92，P=0.04）。在 22 例接受克唑替尼治疗的患者中，中位无进展生存期为 7.4 个月。
对于 METex14 NSCLC 患者，MET 抑制剂治疗可改善总生存期。
